Lessons learned from an unusually aggressive recurrent dermatofibrosarcoma protuberans with chest wall involvement: A case report
Dermatofibrosarcoma protuberans (DFSP) is a rare, slow-growing soft-tissue sarcoma with low metastatic potential. This report describes an unusual case of aggressive, recurrent DFSP in a 50-year-old female, characterized by extensive chest wall involvement despite multiple surgeries, radiation, and targeted therapy. The clinical course was complicated by poor wound healing, infection, and severe ulceration. This case highlights the potential for aggressive local progression, the difficulty of achieving durable local control in recurrent DFSP, and the limitations of systemic therapies for locally advanced disease. The case also emphasizes the importance of a multidisciplinary approach, patient education, and palliative care, especially in resource-limited settings. This report underscores the need for continued research into new treatments for aggressive DFSP.
- Brooks J, Ramsey ML. Dermatofibrosarcoma protuberans. In: StatPearls. Treasure Island, FL: StatPearls Publishing; 2024. Available from: https://www.ncbi.nlm.nih.gov/books/ nbk513305 [Last accessed on 2025 May 05].
- Li Y, Wang C, Xiang B, Chen S, Li L, Ji Y. Clinical features, pathological findings and treatment of recurrent dermatofibrosarcoma protuberans. J Cancer. 2017;8: 1319-1323. doi: 10.7150/jca.17988
- National Comprehensive Cancer Network. Dermatofibrosarcoma Protuberans. National Comprehensive Cancer Network; 2025. Available from: https://www.nccn. org/guidelines/guidelines-detail?category=1&id=1430 [Last accessed on 2025 Apr 29].
- Ugurel S, Mentzel T, Utikal J, et al. Neoadjuvant imatinib in advanced primary or locally recurrent dermatofibrosarcoma protuberans: A multicenter phase II DeCOG trial with long-term follow-up. Clin Cancer Res. 2014;20(2):499-510. doi: 10.1158/1078-0432.ccr-13-1411
- Noujaim J, Thway K, Fisher C, Jones RL. Dermatofibrosarcoma protuberans: From translocation to targeted therapy. Cancer Biol Med. 2015;12(4):375-384. doi: 10.7497/j.issn.2095-3941.2015.0067
- Ugurel S, Becker JC. Imatinib in dermatofibrosarcoma: Targeted therapy or immunotherapy? J Invest Dermatol. 2017;137(2):277-279. doi: 10.1016/j.jid.2016.10.027
- Labropoulos SV, Razis ED. Imatinib in the treatment of dermatofibrosarcoma protuberans. Biologics. 2007;1(4): 347-353.
- Agyeman MB, Vanderpuye VD, Yarney J. Abscopal effect of radiotherapy in imatinib-resistant dermatofibrosarcoma protuberans. Cureus. 2019;11(1):e3857. doi: 10.7759/cureus.3857
- Xiong JX, Cai T, Hu L, et al. Risk factors related to postoperative recurrence of dermatofibrosarcoma protuberans: A retrospective study and literature review. World J Clin Cases. 2021;9(20):5442-5452. doi: 10.12998/wjcc.v9.i20.5442
- Baig IT, Lauck K, Nguyen QD. Tumor size is the most significant risk factor for local recurrence in dermatofibrosarcoma protuberans: A large-scale retrospective cohort analysis. J Am Acad Dermatol. 2023;89(5):1054-1056. doi: 10.1016/j.jaad.2023.06.044
- Iqbal N, Iqbal N. Imatinib: A breakthrough of targeted therapy in cancer. Chemother Res Pract. 2014;2014:357027. doi: 10.1155/2014/357027
- Rieger CD, Soliman AM, Kaplia K, et al. The antimicrobial potential of traditional remedies of Indigenous peoples from Canada against MRSA planktonic and biofilm bacteria in wound infection mimetic conditions. Microbiol Spectr. 2024;12:e0234124. doi: 10.1128/spectrum.02341-24
- Saifuddin H, Yan M, Jakub J, Martinez-Jorge J, Roenigk R, Vijayasekaran A. Wide local excision, Mohs micrographic surgery, and reconstructive options for treatment of dermatofibrosarcoma protuberans of the breast: A retrospective case series from Mayo Clinic. World J Surg Oncol. 2023;21:141. doi: 10.1186/s12957-023-03022-9
- Theriot T, Haas C. A case of highly recurrent DFSP: Treatment dilemmas and considerations. Case Rep Dermatol Med. 2025;2025:6640596. doi: 10.1155/crdm/6640596
